Inter- and Intra-Operator Variability in the Reading of Indirect Immunofluorescence Assays for the Serological Diagnosis of Scrub Typhus and Murine Typhus

Title
Inter- and Intra-Operator Variability in the Reading of Indirect Immunofluorescence Assays for the Serological Diagnosis of Scrub Typhus and Murine Typhus
Authors
Phetsouvanh, R; Thojaikong, T; Phoumin, P; Sibounheuang, B; Phommasone, K; Chansamouth, V; Lee, SJ; Newton, PN; Blacksell, SD
Issue Date
2013
Publisher
AMER SOC TROP MED & HYGIENE
Citation
AMERICAN JOURNAL OF TROPICAL MEDICINE AND HYGIENE; Vol.88 5; 932-936
Abstract
Inter- and intra-observer variation was examined among six microscopists who read 50 scrub typhus (ST) and murine typhus (MT) indirect immunofluorescence assay (IFA) immunoglobulin M (IgM) slides. Inter-observer agreement was moderate (kappa = 0.45) for MT and fair (kappa = 0.32) for ST, and was significantly correlated with experience (P = 0.03 and P = 0.004, respectively); kappa-scores for intra-observer agreement between morning and afternoon readings (range = 0.35-0.86) were not correlated between years of experience for ST and MT IFAs (Spearman's rho = 0.31, P = 0.54 and P = 0.14, respectively; P = 0.78). Storage at 4 degrees C for 2 days showed a change from positive to negative in 20-32% of slides. Although the titers did not dramatically change after 14 days of storage, the final interpretation (positive to negative) did change in 36-50% of samples, and it, therefore, recommended that slides should be read as soon as possible after processing.
URI
http://hdl.handle.net/11267/1858
ISSN
0002-9637
Appears in Collections:
5.Mahosot Hospital > Journal articles
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